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Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a department of veterans affairs cooperative study.
Arch Gen Psychiatry. 2003 May; 60(5):481-9.AG

Abstract

BACKGROUND

Department of Veterans Affairs Cooperative Study 420 is a randomized clinical trial of 2 methods of group psychotherapy for treating posttraumatic stress disorder (PTSD) in male Vietnam veterans.

METHODS

Vietnam veterans (360 men) were randomly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus. Treatment was provided weekly to groups of 6 members for 30 weeks, followed by 5 monthly booster sessions. Severity of PTSD was the primary outcome. Additional measures were other psychiatric symptoms, functional status, quality of life, physical health, and service utilization. Follow-up assessments were conducted at the end of treatment (7 months) and at the end of the booster sessions (12 months); 325 individuals participated in 1 or both assessments. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months.

RESULTS

Although posttreatment assessments of PTSD severity and other measures were significantly improved from baseline, intention-to-treat analyses found no overall differences between therapy groups on any outcome. Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy reduced avoidance and numbing and, possibly, PTSD symptoms. Dropout from treatment was higher in trauma-focused group treatment. Average improvement was modest in both treatments, although approximately 40% of participants showed clinically significant change.

CONCLUSIONS

This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings.

Authors+Show Affiliations

Department of Veterans Affairs (VA) National Center for Posttraumatic Stres Disorder, White River Junction, VT 05009, USA. paula.schnurr@dartmouth.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

12742869

Citation

Schnurr, Paula P., et al. "Randomized Trial of Trauma-focused Group Therapy for Posttraumatic Stress Disorder: Results From a Department of Veterans Affairs Cooperative Study." Archives of General Psychiatry, vol. 60, no. 5, 2003, pp. 481-9.
Schnurr PP, Friedman MJ, Foy DW, et al. Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a department of veterans affairs cooperative study. Arch Gen Psychiatry. 2003;60(5):481-9.
Schnurr, P. P., Friedman, M. J., Foy, D. W., Shea, M. T., Hsieh, F. Y., Lavori, P. W., Glynn, S. M., Wattenberg, M., & Bernardy, N. C. (2003). Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a department of veterans affairs cooperative study. Archives of General Psychiatry, 60(5), 481-9.
Schnurr PP, et al. Randomized Trial of Trauma-focused Group Therapy for Posttraumatic Stress Disorder: Results From a Department of Veterans Affairs Cooperative Study. Arch Gen Psychiatry. 2003;60(5):481-9. PubMed PMID: 12742869.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized trial of trauma-focused group therapy for posttraumatic stress disorder: results from a department of veterans affairs cooperative study. AU - Schnurr,Paula P, AU - Friedman,Matthew J, AU - Foy,David W, AU - Shea,M Tracie, AU - Hsieh,Frank Y, AU - Lavori,Philip W, AU - Glynn,Shirley M, AU - Wattenberg,Melissa, AU - Bernardy,Nancy C, PY - 2003/5/14/pubmed PY - 2003/6/6/medline PY - 2003/5/14/entrez SP - 481 EP - 9 JF - Archives of general psychiatry JO - Arch Gen Psychiatry VL - 60 IS - 5 N2 - BACKGROUND: Department of Veterans Affairs Cooperative Study 420 is a randomized clinical trial of 2 methods of group psychotherapy for treating posttraumatic stress disorder (PTSD) in male Vietnam veterans. METHODS: Vietnam veterans (360 men) were randomly assigned to receive trauma-focused group psychotherapy or a present-centered comparison treatment that avoided trauma focus. Treatment was provided weekly to groups of 6 members for 30 weeks, followed by 5 monthly booster sessions. Severity of PTSD was the primary outcome. Additional measures were other psychiatric symptoms, functional status, quality of life, physical health, and service utilization. Follow-up assessments were conducted at the end of treatment (7 months) and at the end of the booster sessions (12 months); 325 individuals participated in 1 or both assessments. Additional follow-up for PTSD severity was performed in a subset of participants at 18 and 24 months. RESULTS: Although posttreatment assessments of PTSD severity and other measures were significantly improved from baseline, intention-to-treat analyses found no overall differences between therapy groups on any outcome. Analyses of data from participants who received an adequate dose of treatment suggested that trauma-focused group therapy reduced avoidance and numbing and, possibly, PTSD symptoms. Dropout from treatment was higher in trauma-focused group treatment. Average improvement was modest in both treatments, although approximately 40% of participants showed clinically significant change. CONCLUSIONS: This study did not find a treatment effect for trauma-focused group therapy. The difference between the effectiveness and adequate dose findings suggests the possible value of methods to enhance the delivery of cognitive-behavioral treatments in clinical practice settings. SN - 0003-990X UR - https://www.unboundmedicine.com/medline/citation/12742869/Randomized_trial_of_trauma_focused_group_therapy_for_posttraumatic_stress_disorder:_results_from_a_department_of_veterans_affairs_cooperative_study_ L2 - https://jamanetwork.com/journals/jamapsychiatry/fullarticle/vol/60/pg/481 DB - PRIME DP - Unbound Medicine ER -